The art and science of cytopathology

July 19, 2006

Diagnostic cytologist isn’t a job description that trips lightly off the tongue. But then, what diagnostic cytologists do isn’t to be taken lightly either.

They are the folk in white lab coats who study human cell samples for signs of abnormalities that indicate pre-cancerous changes in the body’s organs such as the liver or the lungs, cancers and some infections.

Unsurprisingly, Eileen McDonald, a faculty member at the Michener Institute of Applied Health Sciences, says, “We have to have a very high level of accuracy in what we do.”

McDonald, a diagnostic cytologist herself and a 1981 graduate of the Michener program, also says that the job isn’t all science. Some of it is an art, she continues, explaining that diagnostic cytologists look for patterns in the cells under the microscope and changes in their shape, colour and size. In fact, the textbook the students use is called “The Art and Science of Cytopathology.”

The bulk of the diagnostic cytologist’s work — some 80% according to McDonald — comes from pap smears, a medical test for women to check for cervical cancer. The other 20% covers non-gynecologic examinations, including those for the lungs, liver, bladder and lymph nodes.

Getting into the Michener program is competitive. McDonald says it’s the only one in Ontario, with an annual intake in September and about 150 applicants for the 12 places available. To be considered for the program, which takes 60 weeks, applicants must have a medical laboratory technologist’s advanced diploma or a science degree with credits in human anatomy and human physiology. Teaching in the program is one to one, says McDonald, noting that students are instructed on double-headed microscopes.

The program’s course load is spread over four 15-week semesters. McDonald says students learn in the labs at the Michener and through distance education, so they’ll need a computer. There’s also a hospital clinical placement they will have to complete at no pay, and a final exam administered by the Canadian Society for Medical Laboratory Science. Graduates must pass the national examination before they can register with the College of Medical Laboratory Technologists of Ontario and start work in the province. Tuition costs about $4,500 a year.

Catherine Brown, another Michener faculty member, 1980 graduate and a teacher in the program for 18 years, says, “I believe the students (in diagnostic cytology) are much more mature. Across all programs their age has increased.”

Brown says the age of the students in her program is now late 20s rather than early 20s, a change she says comes in part from foreign-trained doctors in the course learning a new skill.

Another change, Brown says, is the business of diagnostic cytology. There’s far greater regulation these days, she says, and terminology and recommendations for follow up have become uniform. Equipment too has improved, of course, although Brown points out the actual work of the diagnostic cytologist hasn’t.

Most of the graduates of the Michener program will find themselves working in a private lab, with the rest going on to find employment in hospitals. McDonald says the job outlook for her students is very good, with more than 90% of them working in the field within one year of graduation. The pay isn’t bad either. She says new diagnostic cytologists begin at about $24 an hour, with more senior staff earning about $35 an hour.

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Quick Facts

– The diagnostic cytology program at the Michener Institute lasts 60 weeks.

– Only 12 students are accepted into the program each year.

– Instruction is given in labs at the Institute and through distance learning.

– Applicants must have a medical lab technologist’s diploma or a science degree with credits in human anatomy and physiology.